Clinical values of using noninvasive NIPPV ventilation in the treatment of chronic obstructive pulmonary diseases and typeIIrespiratory failure

Objective To explore the clinical values of using noninvasive positive pressure ventilation(NIPPV) in the treatment of chronic obstructive pulmonary diseases(COPD)and typeⅡrespiratory failure.Methods Sixty-two patients with COPD and typeⅡrespiratory failure were treated by NIPPV on the basis of routine therapy and followed up.They were divided into two groups:NIPPV success group and NIPPV failure group.The respiratory rate(RR),heart rate(HR)and blood gas parameters of the two groups were determined before and after ventilation.Results Dyspnea and blood gas parameters improved markedly in 56 patients after NIPPV therapy,with a success rate 82.4%.Twelve patients had no response or deteriorated after 48h NIPPV therapy and needed endotracheal intubation and invasive ventilation.The failure rate of NIPPV was 17.6%.Seven patients(10.3%)died and 5 patients(7.4%)survived.The total suceess rate was 89.9% in this group.Conclusion The patients with COPD and type Ⅱ respiratory failure should be treated early with NIPPV.If clinical symptoms and blood gas parameters remain unchanged or even deteriorate after 48h NIPPV therapy,invasive ventilation should be used in replacement promptly.